Cone-beam computerized tomography fluoroscopy-guided percutaneous drainage for the treatment of leakage after laparoscopic sleeve gastrectomy

Year 2024, Volume: 29 Issue: 1, 29 - 36, 27.01.2024

Mustafa Orhan Nalbant , Çağlayan Çakır

https://doi.org/10.21673/anadoluklin.1298036

Abstract

Aim: This study aimed to review the technical and clinical results of cone-beam computed tomography (CBCT) fluoroscopy-guided drainage of anastomosis or staple line leakage, which is the most important complication after laparoscopic sleeve gastrectomy due to obesity.

Methods: A retrospective analysis was performed of the demographic findings, clinical manifestations, leakage location, and medical data of 30 cases who underwent CBCT fluoroscopy-guided percutaneous drainage due to anastomosis or staple line leakage after sleeve gastrectomy due to obesity in the interventional unit of our hospital between February 2015 and September 2020.

Results: A total of 48 drainage catheters were inserted in 30 patients (8 females and 22 males), aged 19–71 years (mean 51.24), under the guidance of CBCT fluoroscopy. Drainage was completed in a single session with one catheter in 13 (43.3%) patients. In 17 (56.7%) patients, the procedure was completed with two or more catheterizations in more than one session due to different leakage locations and subsequent occlusion or dislocation of the catheter. Inflammatory parameters and symptoms related to leakage regressed in 29 (94%) patients within 48–72 hours with clinical improvement. The success rate of percutaneous drainage was 100% without any complications.

Conclusion: Anastomosis, or staple line leakage, is one of the most serious life-threatening complications that can be seen following laparoscopic sleeve gastrectomy. CBCT fluoroscopy-guided drainage is a safe, highly effective, and minimally invasive treatment option that has a low risk of complications. This technique can facilitate the treatment of postoperative collections with alternative treatment methods.

Keywords

Cone-beam computerized tomography, drainage, fluoroscopy, gastrectomy

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors

Thanks

Dear Editor, We would like to submit our enclosed manuscript entitled “Cone-Beam CT Fluoroscopy-Guided Percutaneous Drainage for the Treatment of Leakage After Laparoscopic Sleeve Gastrectomy” to publish in Anatolian Clinic the Journal of Medical Science. Thank you very much for your interest and we are looking forward to hearing from you very soon. Sincerely yours,

Laparoskopik sleeve gastrektomi sonrası kaçak tedavisinde konik ışınlı bilgisayarlı tomografi floroskopi kılavuzluğunda perkütan drenaj

Abstract

Amaç: Bu çalışmanın amacı, obeziteye bağlı laparoskopik sleeve gastrektomi sonrası en önemli komplikasyon olan Konik Işınlı Bilgisayarlı Tomografi (KIBT) floroskopi kılavuzluğunda anastomoz veya stapler hattı kaçağı drenajının teknik ve klinik sonuçlarını gözden geçirmektir.

Yöntemler: Hastanemiz girişimsel radyoloji ünitesinde Şubat 2015 ve Eylül 2020 yılları arasında obezite nedeniyle sleeve gastrektomi sonrası anastomoz veya stapler hattı kaçağı nedeniyle KIBT floroskopi kılavuzluğunda perkütan drenaj uygulanan 30 olgunun demografik bulguları, klinik bulguları, kaçak yeri ve tıbbi verilerinin retrospektif olarak analizi yapıldı.

Bulgular: Yaşları 19-71 (ortalama 51.24) olan 30 hastaya (8 kadın, 22 erkek) KIBT floroskopi eşliğinde toplam 48 drenaj kateteri yerleştirildi. 13 (%43.3) hastada tek kateter ile tek seansta drenaj tamamlandı. 17 (%56.7) hastada ise farklı kaçak yerleri ve sonrasında kateterin tıkanması veya yerinden çıkması nedeniyle iki veya daha fazla kateterizasyon birden fazla seansta uygulanarak işlem tamamlandı. Enflamatuvar parametreler ve sızıntıya bağlı semptomlar 48-72 saat içinde 29 (%94) hastada klinik düzelme ile geriledi. Perkütan drenaj uygulamasının başarı oranı herhangi bir komplikasyon olmaksızın %100 idi.

Sonuç: Anastomoz veya stapler hattı kaçağı, laparoskopik sleeve gastrektomi sonrası görülebilen hayatı tehdit eden en ciddi komplikasyonlardan biridir. KIBT floroskopi kılavuzluğunda drenaj, düşük komplikasyon riski ile minimal invaziv, güvenli ve oldukça etkili bir tedavi seçeneğidir. Bu teknik, alternatif tedavi yöntemleri ile postoperatif koleksiyonların tedavisini kolaylaştırabilir.

Keywords

Drenaj, floroskopi, gastrektomi, konik ışınlı bilgisayarlı tomografi

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